Young patients with myocardial infarction who don’t have obstructed coronary arteries tend to be female, have heterogeneous mechanistic profiles, and had similar outcomes to those experiencing MI from coronary artery disease, new study results suggested. Study researchers, publishing the results of the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study in the Journal of the American Heart Association, enrolled acute MI patients at a 2:1 ratio of women to men, with key outcomes set as one- and 12-month mortality and functional SAQ and psychosocial status.
Young patients w/ MINOCA were more likely women, had a heterogeneous mechanistic profile, and had clinical outcomes comparable to those of MI‐CAD patients https://t.co/klowQy517w
— JAHA (@JAHA_AHA) June 29, 2018
According to the results, 299 (11.1%) of the patient population presented with MI with no obstructed coronary arteries. Women had a five-fold higher risk of having MI without obstructed coronary arteries than men in the study population did. Those presenting with MI and no obstructed arteries also were more likely to be without traditional cardiovascular risk factors and were more prone to hypercoagulable states than those with coronary artery disease. Women with MI who had coronary artery disease were more likely to be in menopause than those presenting without obstructed arteries and to have a history of gestational diabetes.
“Patients with MI without obstructed coronary arteries had similar outcomes, including mortality and psychosocial and functional status, to MI patients with coronary artery disease,” the authors concluded. “The clinical profile and management of [these] patients varied by sex and phenotype. Further work is needed to better characterize these patients based on the underlying mechanism.”
— Dorian L. Beasley MD, FACC (Troponin Steward) (@cardiojaydoc02) July 3, 2018
MINOCA: there is much more than obstructive #coronary epicardial #atherosclerosis causing ischemia including #microvascular disease, #vasospasm & #endothelial dysfxn, & most importantly non-obstructive #CAD.@emorywomenheart #angina @CMichaelGibson https://t.co/HsR3X9RLt1
— Parham Eshtehardi MD (@CoronaryDoc) July 5, 2018